Yes. Plans vary by state and not all discount or low-cost senior dental plans cover the same services. Some have limited services or only pay so much per year before they max out on benefits. Some may not cover routine care, such as cleanings. It is important to compare dental plans and look for value rather than just for lower monthly premiums. Your goal is always to find the best plan that fits your dental needs and budget.
If you read our article on discount dental plans, you may think we are 100% against dental insurance. We are not. We simply know seniors can get sucked into paying high premiums with equally high out-of-pocket costs with no major insurance advantage. But, affordable dental insurance for seniors is possible that balances the right premiums, out-of-pocket costs, and coverage.
Humana group dental plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, Humana Health Benefit Plan of Louisiana, The Dental Concern, Inc., Humana Medical Plan of Utah, CompBenefits Company, CompBenefits Insurance Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., or DentiCare, Inc. (DBA CompBenefits).
Dental health is an important part of your overall wellness, and not having insurance may tempt you to skip regular cleanings and checkups – a decision that could lead to serious dental health problems down the road. Spirit Individual Dental Insurance plans are designed to help fill these types of gaps by offering a variety of plans and price points.
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Dental insurance companies divide benefits, services, or procedures into categories and refer to them with American Dental Association (ADA) 3-4 digit code. As an example, Preventative and Diagnostic procedures often include exams (ADA code 0120), x-rays (ADA code 0210), and basic cleanings or prophylaxis (ADA code 1110). Basic procedures often include fillings, periodontics, endodontics, and oral surgery. Major procedures often are crowns, dentures, and implants. Procedures such as periodontics, endodontics, and oral surgery may be considered major, depending on the policy.
3In WY, you don’t need to select a primary care dentist, but you must visit a DeltaCare USA dentist to receive benefits. In the following states, you can maximize your savings when you visit a DeltaCare USA dentist, although you may visit any licensed dentist and receive out-of-network coverage: AK, CT, LA, ME, MS, MT, NC, ND, NH, OK, SD, VT. Refer to your Policy for details about your out-of-network benefits.
Humana has a loyalty rewards dental program which increases coverage over time, making it an attractive choice for seniors seeking dental coverage. Plans, coverage options and premium vary by state. Another great option for seniors is the ability to purchase vision insurance in combination with the Humana dental plan. If you purchase both individual dental and
Generally dental offices have a fee schedule, or a list of prices for the dental services or procedures they offer. Dental insurance companies have similar fee schedules which is generally based on Usual and Customary dental services, an average of fees in an area. The fee schedule is commonly used as the transactional instrument between the insurance company, dental office and/or dentist, and the consumer.
Our dental insurance plans offer affordable options for dental coverage. The plans have low deductibles to satisfy and multiple options for the maximum amount they pay each year. Our dental insurance plans offer lifetime deductibles (not calendar year), there are no benefit waiting periods, three cleanings are covered per year, adult dental implants are covered, and you can select from various maximum benefit amounts.
In either case, in our opinion, the purchase of dental insurance can be hard if you don’t do your homework. Why? The premiums aren’t in favor of the benefit. For example, if you are paying $100 per month for dental insurance which has an annual benefit of $1,000, that really isn’t in your best interest. You are paying $1,200 annually for a $1,000 benefit. In this case, it is better to simply negotiate a discount with the dentist or utilize a dental discount plan where appropriate (more on that below).
1DeltaCare USA is underwritten in these states by these entities: AL — Alpha Dental of Alabama, Inc.; AZ — Alpha Dental of Arizona, Inc.; CA — Delta Dental of California; AR, CO, IA, MA, ME, MI, MN, NC, ND, NE, NH, OK, OR, RI, SC, SD, VT, WA, WI, WY — Dentegra Insurance Company; AK, CT, DC, DE, FL, GA, KS, LA, MS, MT, TN, WV — Delta Dental Insurance Company; HI, ID, IL, IN, KY, MD, MO, NJ, OH, TX — Alpha Dental Programs, Inc.; NV — Alpha Dental of Nevada, Inc.; UT — Alpha Dental of Utah, Inc.; NM — Alpha Dental of New Mexico, Inc.; NY — Delta Dental of New York, Inc.; PA — Delta Dental of Pennsylvania; VA – Delta Dental of Virginia. Delta Dental Insurance Company acts as the DeltaCare USA administrator in all these states. These companies are financially responsible for their own products. The plan is a dental HMO in CA and TX.
How you define “cost” is important. Generally a single plate – upper or lower- costs between $1,200 and $3,800. So, for a full set of dentures could cost in the $7,500 range. Those higher costs usually include other services such as extractions, mold production, and fittings. Again, the actual cost is dependent upon the senior’s oral health, and the amount of service needed. Don’t be afraid to shop around from one dentist to the next to see if there is a price break.
DHMO's are similar to HMOs in that their plans connect you with a network of dentists who give you care for a low monthly premium. With DHMO plans, you are required to go see dentists who are in their network, but in return you have lower costs, and no claim forms to fill out. DHMOs are great for preventative care and basic procedures. Some downsides include that there can be wait times if you need major or restorative dental care and some DHMOs don’t cover this types of treatment. You also need to go see your primary care dentist and get a referral to a specialist in order to get some specialized care.
The benefits of choosing MetLife are that they have a number of different plans available and they are well respected within the dental insurance industry. They have a broad network of dentists who work with them and they have significant coverage with a low deductible. The downside is that you have to visit dentists within their network in order to save.
Dental Health Maintenance Organization plans entail dentists contracting with a dental insurance company that dentists agree to accept an insurance fee schedule and give their customers a reduced cost for services as an In-Network Provider. Many DHMO insurance plans have little or no waiting periods and no annual maximum benefit limitations, while covering major dental work near the start of the policy period. This plan is sometimes purchased to help defray the high cost of the dental procedures. Some dental insurance plans offer free semi-annual preventative treatment. Fillings, crowns, implants, and dentures may have various limitations.
Aetna is based in Connecticut and was founded in 1853. They have over 30 million customers worldwide. They offer a number of different types of plans including DHMO plans where you pay a lower cost for your plan, but have to see a dentist in your network and need to get preauthorization if you need to be referred for specialty care. They also offer network option plans or PPO plans. These plans are more expensive and you have to pay 50% or more of the costs of your care. While you can see a dentist outside the network with these plans, they have many PPO dentist that you can use for a discounted rate. If you go out-of-network you will have to pay and get reimbursed later. You can also choose hybrid plans that offer some of the benefits of more than one plan.
Nothing on this website guarantees eligibility, coverage, or payment, or determines or guarantees the benefits, limitations or exclusions of your coverage. For a complete description of the details of your coverage, please refer to your coverage documents. Estimates may vary depending on your benefit plan and the state you live in. Claims will be processed when received according to your plan provisions.
Although discount plans are also sold by private companies, they are not insurance plans. There are no copays, coinsurance, or deductible amounts. That also means that there are no pre-negotiated rates or free yearly checkups and cleanings. A participating dentist simply agrees to offer discounts (often a percentage off from the total price) for certain medical services. Then, seniors who choose discount plans will pay their dentist directly for the cost of services (after the discount).
Choosing a plan that’s right for you depends on many factors, including the ages and number of people in your family, and whether you or a family member needs orthodontic care. Some dental plans provide low copays, while others provide discounts on services. No matter which plan you select, you’ll have access to a large network of dental providers.